Organization
ANAHEIM PHARMACY, LLC
Active
Other names
ANAHEIM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAY KIM (MANAGING MEMBER)
(909) 464-0300
Entity
Organization
Contact information
Practice address
1211 W LA PALMA AVE STE 102, ANAHEIM, CA 92801-2809
(714) 442-1141
(714) 442-1142
Mailing address
1211 W LA PALMA AVE STE 102, ANAHEIM, CA 92801-2809
(714) 442-1141
(714) 442-1141
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285363556
—
CA
Enumeration date
06/10/2022
Last updated
09/29/2025
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